Early thrombolysis is associated with decreased operative mortality in postinfarction ventricular septal rupture.
Aged
Coronary Artery Bypass
Female
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction
/ complications
Postoperative Complications
/ mortality
Preoperative Care
Retrospective Studies
Risk Factors
Shock, Cardiogenic
/ etiology
Thrombolytic Therapy
Treatment Outcome
Ventricular Septal Rupture
/ etiology
Early thrombolysis
Outcomes
Post–myocardial infarction
Risk factors
Ventricular septal rupture
Journal
Indian heart journal
ISSN: 2213-3763
Titre abrégé: Indian Heart J
Pays: India
ID NLM: 0374675
Informations de publication
Date de publication:
Historique:
received:
10
02
2019
accepted:
26
04
2019
entrez:
24
9
2019
pubmed:
24
9
2019
medline:
26
2
2020
Statut:
ppublish
Résumé
Post myocardial infarction ventricular septal rupture (PMI-VSR) is a dreaded mechanical complication of acute coronary syndromes. Given that surgical mortality approaches 50%, it is pragmatic that the risk factors for mortality and outcomes after surgical correction of PMI- VSR are carefully scrutinized. We performed a single-center, retrospective cohort study of 35 patients presenting for surgical closure of post myocardial infarction ventricular septal rupture over six years. We reviewed patient characteristics, clinical, echocardiographic, angiographic and perioperative risk factors which may affect mortality after surgical repair of PMIVSR and 30 day and one year mortality rates of these patients. Univariate and multivariate logistic and cox proportional hazard regression analysis was used to identify predictors of operative and overall mortality. Long term survival was presented with Kaplan-Meier Survival Curve. Sixteen patients (46%) were in cardiogenic shock. Concomitant coronary artery bypass grafting (CABG) was done in 22 patients (63%) but did not influence survival. Preoperative thrombolysis was done in 12 patients (34%) out of which 10 (53%) survived Operative mortality was 46% and one-year mortality was 49%. Multivariate analysis identified preoperative thrombolysis: Hazards ratio, 0.12; 95% CI, 0.02-0.61; p value of 0.01, as significant independent predictor of survival in PMIVSR cohort. Preoperative thrombolysis is associated with decreased odds of operative and overall mortality after surgical repair in PMIVSR patients.
Sections du résumé
BACKGROUND
BACKGROUND
Post myocardial infarction ventricular septal rupture (PMI-VSR) is a dreaded mechanical complication of acute coronary syndromes. Given that surgical mortality approaches 50%, it is pragmatic that the risk factors for mortality and outcomes after surgical correction of PMI- VSR are carefully scrutinized.
METHODS
METHODS
We performed a single-center, retrospective cohort study of 35 patients presenting for surgical closure of post myocardial infarction ventricular septal rupture over six years. We reviewed patient characteristics, clinical, echocardiographic, angiographic and perioperative risk factors which may affect mortality after surgical repair of PMIVSR and 30 day and one year mortality rates of these patients. Univariate and multivariate logistic and cox proportional hazard regression analysis was used to identify predictors of operative and overall mortality. Long term survival was presented with Kaplan-Meier Survival Curve.
RESULTS
RESULTS
Sixteen patients (46%) were in cardiogenic shock. Concomitant coronary artery bypass grafting (CABG) was done in 22 patients (63%) but did not influence survival. Preoperative thrombolysis was done in 12 patients (34%) out of which 10 (53%) survived Operative mortality was 46% and one-year mortality was 49%. Multivariate analysis identified preoperative thrombolysis: Hazards ratio, 0.12; 95% CI, 0.02-0.61; p value of 0.01, as significant independent predictor of survival in PMIVSR cohort.
CONCLUSIONS
CONCLUSIONS
Preoperative thrombolysis is associated with decreased odds of operative and overall mortality after surgical repair in PMIVSR patients.
Identifiants
pubmed: 31543194
pii: S0019-4832(19)30072-0
doi: 10.1016/j.ihj.2019.04.011
pmc: PMC6796617
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
224-228Informations de copyright
Copyright © 2019 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
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